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Kawasaki disease—sudden death as the first presenting symptom

Published online by Cambridge University Press:  19 August 2008

Louis Tsun-cheung Chow ,
Wing-hing Chow ,
Christopher Chun-hing Tse ,
Eric Hon-man Wong ,
Koon-sang Wong  and
David Chi-pang Yip
Louis Tsun-cheung Chow*
Affiliation:
From the Institute of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong
Wing-hing Chow
Affiliation:
Department of Medicine, Grantham Hospital, Aberdeen, Hong Kong
Christopher Chun-hing Tse
Affiliation:
From the Institute of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong
Eric Hon-man Wong
Affiliation:
Forensic Pathology Service, Department of Health, Hong Kong
Koon-sang Wong
Affiliation:
Forensic Pathology Service, Department of Health, Hong Kong
David Chi-pang Yip
Affiliation:
Forensic Pathology Service, Department of Health, Hong Kong
*
Dr. Louis T.C. Chow, Institute of Pathology, Queen Elizabeth Hospital, Wylie Road, Kowloon, Hong Kong. Tel. 852–710–2816; Fax. 852–385–2455
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Summary

Two patients are described with sudden death as the first presenting symptom of Kawasaki disease. The first patient died of cardiac tamponade as a result of rupture of a coronary arterial aneurysm at the age of three months and nineteen days. The second patient, one and half years old, developed acute myocardial infarction secondary to coronary arterial aneurysm and thrombosis. The true nature of their underlying disease was realized only after postmortem examination. Their clinical signs and symptoms of Kawasaki disease might be so mild as to escape recognition. A high index of suspicion should be exercised by the clinician in order not to miss this condition, especially in places where Kawasaki disease is uncommon.

Keywords

Kawasaki diseasesudden deathcoronary aneurysmcoronary arteritis
Type
Original Articles
Information
Cardiology in the Young , Volume 2 , Issue 1 , January 1992 , pp. 73 - 77
Copyright
Copyright © Cambridge University Press 1992

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References

1.Kawasaki, T, Kosaki, F, Okawa, S. A new infantile febrile mucocutaneous lymph node syndrome prevailing in Japan. Pediatrics 1974; 54: 271–276.CrossRefGoogle ScholarPubMed
2.Morens, DM, Anderson, LJ, Hurwitz, ES. National surveillance of Kawasaki disease. Pediatrics 1980; 65: 21–25.CrossRefGoogle ScholarPubMed
3.Kato, H, Inoue, O, Akagi, T. Kawasaki disease: cardiac problems and management. Pediatrics in review 1988; 9: 209–217.CrossRefGoogle ScholarPubMed
4.Newburger, JW, Burns, JC. Kawasaki syndrome. Cardiol Clin 1987; 7: 453–465.CrossRefGoogle Scholar
5.Kato, H, Ichinose, E, Kawasaki, T. Myocardial infarction in Kawasaki disease: Clinical analyses in 195 cases. J Pediatr 1986; 108: 923–927.CrossRefGoogle ScholarPubMed
6.Suzuki, A, Kamiya, T, Kuwahara, N. Coronary arterial lesion of Kawasaki disease: Cardiac catheterization findings of 1100 cases. Pediatr Cardiol 1986; 7: 3–9.CrossRefGoogle ScholarPubMed
7.Ichida, F, Fatica, NS, Engle, MA. Coronary artery involvement in Kawasaki syndrome in Manhattan, New York: Risk factors and role of aspirin. Pediatrics 1987; 80: 828–835.Google ScholarPubMed
8.Furusho, K, Kamiya, T, Nakano, H. High-dose intravenous gamma-globulin for Kawasaki disease. Lancet 1984; 2: 1055–1058.CrossRefGoogle ScholarPubMed
9.Newburger, JW, Takahashi, M, Burns, JC. The treatment of Kawasaki syndrome with intravenous gamma-globulin. N EnglJ Med 1986; 315: 341–347.CrossRefGoogle ScholarPubMed
10.Nagashima, M, Matsushima, M, Matsuoka, H. High-dose gammaglobulin therapy for Kawasaki disease. J Pediatr 1987; 110: 710–712.CrossRefGoogle ScholarPubMed
11.Kawasaki, T. Acute febrile mucocutaneous lymph node syndrome: Clinical observations of 50 cases. Jpn J Allergol 1967; 16: 178–182.Google Scholar
12.Tanaka, N, Seikimoto, K, Naoe, S. Kawasaki disease. Relationship with infantile periarteritis nodosa. Arch Pathol Lab Med 1976; 100: 81–88.Google ScholarPubMed
13.Kegel, SM, Dorsey, TJ, Rowen, M. Cardiac death in mucocutaneous lymph node syndrome. Am J Cardiol 1977; 40: 282–286.CrossRefGoogle ScholarPubMed
14.Fujiwara, H, Hamashima, Y. Pathology of the heart in Kawasaki disease. Pediatrics 1978; 61: 100–107.CrossRefGoogle ScholarPubMed
15.Fujiwara, T, Fujiwara, H, Nakano, H. Pathological features of coronary arteries in children with Kawasaki disease in which coronary arterial aneurysm was absent at autopsy. Circulation 1988; 78: 345–350.CrossRefGoogle ScholarPubMed
16.The Japan Kawasaki Disease Research Committee Diagnostic guidelines of Kawasaki Disease. Fourth Revised Edition, September, 1984.Google Scholar
17.Burns, JC, Wiggins, JW, Toews, WH. Clinical spectrum of Kawasaki disease in infants younger than 6 months of age. J Pediatr 1986; 109: 759–763.CrossRefGoogle Scholar
18.Rowley, AH, Gonzalezcrussi, F, Gidding, SS. Incomplete Kawasaki disease with coronary artery involvement. J Pediatr 1987; 110: 409–414.CrossRefGoogle ScholarPubMed
19.Cloney, DL, Teja, K, Lohr, JA. Fatal case of atypical Kawasaki syndrome. Pediatr Infect Dis J 1987; 6: 297–299.CrossRefGoogle ScholarPubMed
20.Schuh, S, Laxer, RM, Smallhorn, JF. Kawasaki disease with atypical presentation. Pediatr Infect Dis J 1988; 7: 201–203.CrossRefGoogle ScholarPubMed
21.Avner, JR, Shaw, KN, Chin, AJ. Atypical presentation of Kawasaki disease with early development of giant coronary artery aneurysms. J Pediatr 1989; 14: 605–606.CrossRefGoogle Scholar
22.Trillo, AA, Scharyj, M, Prichard, RW. Coronary artery aneurysm and myocardial infarction resulting in sudden death of a 6-year-old child: A case report. Am J Forensic Med Pathol 1980; 1: 349–354.CrossRefGoogle ScholarPubMed
23.Seabra-Gomes, R, Somerville, J, Ross, DN. Congenital coronary artery aneurysms. Br Heart J 1974; 36: 329–335.CrossRefGoogle ScholarPubMed
24.Rowley, A, Shulman, S. Atypical Kawasaki syndrome: Should all children with prolonged unexplained fever undergo echocardiography? Pediatr Res 1986; 20: 320A. [Abstract]Google Scholar